Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 148316 | NY |
NPI | 1023179629 |
---|---|
Provider Name | Gulshan K Malhotra |
First Address | Rego Park, NY 11374-1056 |
Second Address | Rego Park, NY 11374-1056 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B17656 | (02) | NY |